Book contents
- Management of Chronic Pelvic Pain
- Management of Chronic Pelvic Pain
- Copyright page
- Contents
- Contributors
- Foreword
- Chapter 1 Introduction to Chronic Pelvic Pain
- Chapter 2 Neurobiological Basis of Pelvic Pain
- Chapter 3 History and Evaluation of Patients with Chronic Pelvic Pain
- Chapter 4 Psychological Assessment of a Female Patient with Chronic Pelvic Pain
- Chapter 5 Musculoskeletal Assessment for Patients with Pelvic Pain
- Chapter 6 Pharmacological Management of Patients with Pelvic Pain
- Chapter 7 Evidence for Surgery for Pelvic Pain
- Chapter 8 Pelvic Pain Arising from Endometriosis
- Chapter 9 Bladder Pain Syndrome
- Chapter 10 Pelvic Pain Arising from Pelvic Congestion Syndrome
- Chapter 11 Irritable Bowel Syndrome
- Chapter 12 Vulvodynia
- Chapter 13 Pelvic Pain Arising from Adhesive Disease
- Chapter 14 Pelvic Pain Arising from Ovarian Remnant Syndrome
- Chapter 15 Pudendal Neuralgia
- Chapter 16 Other Peripheral Pelvic Neuralgias
- Chapter 17 Chronic Pain After Gynecological Surgery
- Chapter 18 Pain Arising from Pelvic Mesh Implants
- Chapter 19 Treatment of Sexual Dysfunction Arising from Chronic Pelvic Pain
- Chapter 20 Physical Therapy Interventions for Musculoskeletal Impairments in Pelvic Pain
- Chapter 21 If Everything Else Fails
- Index
- References
Chapter 6 - Pharmacological Management of Patients with Pelvic Pain
Published online by Cambridge University Press: 08 March 2021
- Management of Chronic Pelvic Pain
- Management of Chronic Pelvic Pain
- Copyright page
- Contents
- Contributors
- Foreword
- Chapter 1 Introduction to Chronic Pelvic Pain
- Chapter 2 Neurobiological Basis of Pelvic Pain
- Chapter 3 History and Evaluation of Patients with Chronic Pelvic Pain
- Chapter 4 Psychological Assessment of a Female Patient with Chronic Pelvic Pain
- Chapter 5 Musculoskeletal Assessment for Patients with Pelvic Pain
- Chapter 6 Pharmacological Management of Patients with Pelvic Pain
- Chapter 7 Evidence for Surgery for Pelvic Pain
- Chapter 8 Pelvic Pain Arising from Endometriosis
- Chapter 9 Bladder Pain Syndrome
- Chapter 10 Pelvic Pain Arising from Pelvic Congestion Syndrome
- Chapter 11 Irritable Bowel Syndrome
- Chapter 12 Vulvodynia
- Chapter 13 Pelvic Pain Arising from Adhesive Disease
- Chapter 14 Pelvic Pain Arising from Ovarian Remnant Syndrome
- Chapter 15 Pudendal Neuralgia
- Chapter 16 Other Peripheral Pelvic Neuralgias
- Chapter 17 Chronic Pain After Gynecological Surgery
- Chapter 18 Pain Arising from Pelvic Mesh Implants
- Chapter 19 Treatment of Sexual Dysfunction Arising from Chronic Pelvic Pain
- Chapter 20 Physical Therapy Interventions for Musculoskeletal Impairments in Pelvic Pain
- Chapter 21 If Everything Else Fails
- Index
- References
Summary
With worsening drug epidemics in the United States, proper pharmacological management in patients with chronic pelvic pain has very significant consequences. It includes chronic management of those patients as well as perioperative management. Multiple nonnarcotic medications have been shown to be very effective in managing patients with pelvic pain. The mainstay of treatment remains nonsteroidal anti-inflammatory medications. They are effective in any type of pain but particularly in dysmenorrhea and inflammatory pain. Anticonvulsants such as gabapentin have been shown to be effective in neuropathic type of pain as well as pre- and postoperative management. Many patients with pelvic pain develop significant pelvic floor muscle spasm. They do not appear to respond well to oral muscle relaxants but usually have very good responses to vaginal suppositories with various combinations of diazepam and other medications. In patients who do not respond to muscle relaxants botulinum toxin injections to pelvic floor muscles may provide muscle relaxation and therefore pain relief. Patients with pain related to nerves may respond to gabapentin and pregabalin but also benefit from use of lidocaine patches. Narcotics pain medications should be used very cautiously and as a last resort.
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- Management of Chronic Pelvic PainA Practical Manual, pp. 50 - 70Publisher: Cambridge University PressPrint publication year: 2021